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Esophago-rectal reflex. Description and clinical significance
1Department of Surgery and Research, Faculty of Medicine, Cairo University, Egypt.
International Surgery
|January 1, 1993
Summary
The esophago-rectal reflex, triggered by lower esophageal sphincter (LES) distension, causes rectal pressure increases in healthy individuals. This reflex appears impaired in constipated subjects, suggesting a role in bowel regulation.
Area of Science:
- Gastroenterology
- Neurogastroenterology
- Physiology
Background:
- The esophago-rectal reflex is a poorly understood physiological response.
- Its role in bowel function and potential dysfunction in constipation require further investigation.
Purpose of the Study:
- To investigate the esophago-rectal reflex in healthy volunteers and constipated subjects.
- To determine the clinical significance of this reflex in rectal pressure regulation.
Main Methods:
- Utilized a balloon-tipped tube to distend the lower esophageal sphincter (LES) in 19 healthy and 14 constipated individuals.
- Measured rectal and rectal neck pressures using perfused open-ended tubes.
- Recorded pressure responses to graded LES distension (2, 4, 6 ml water).
Main Results:
- LES distension significantly increased rectal pressure in healthy subjects (P < 0.001), dose-dependently.
- Anesthetizing the LES mucosa abolished the rectal pressure response.
- No significant rectal or rectal neck pressure changes were observed in constipated subjects (P > 0.05).
Conclusions:
- The esophago-rectal reflex, mediated via the myenteric plexus, initiates rectal contractions.
- This reflex may signal the rectum to prepare for incoming colonic contents, aiding evacuation.
- Impaired esophago-rectal reflex function could contribute to constipation.